May 20, 2009

Therapy, drug help to treat insomnia

Cognitive behavior therapy and the medication zolpidem taken for six weeks improved sleep in those with persistent insomnia, Canadian researchers found.

Charles M. Morin of the Universite Laval in Quebec City and colleagues evaluated the short- and long-term effects of cognitive behavior therapy singly and combined with the medication zolpidem, for persistent insomnia, and compared treatment strategies to optimize long-term outcomes.

The trial included 160 adults, who were randomized to receive either cognitive behavior therapy alone or cognitive behavior therapy plus 10 mg/d of zolpidem for an initial six-week therapy, followed by extended six-month therapy. The cognitive behavior therapy included recommendations on how to improve sleep and education regarding faulty beliefs and misconceptions about sleep.

The study, published in the Journal of the American Medical Association, found that cognitive behavior therapy used singly, or in combination with zolpidem, produced significant improvements in the amount of time that it took to fall asleep, time awake after falling to sleep and sleep efficiency during initial therapy.

A larger increase of sleep time was obtained with the combined approach. After six weeks, the proportion of patients who responded to treatment of cognitive behavior therapy alone were 60 percent or cognitive behavior therapy plus zolpidem 61 percent.